Hospital-level care coordination strategies associated with better patient experience

Figueroa, José F.; Feyman, Yevgeniy; Zhou, Xiner; Maddox, Karen E. Joynt

doi:10.1136/bmjqs-2017-007597

Cited by 19 publications

(32 citation statements)

References 16 publications

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“…Utilizing patient-centered communication guidelines and codes of conduct, such as physicians’ humility and communication training for physicians and medical students, may bring better patient experience and diminish patient complaints [70,73-76]. As for coordination and integration of care, as necessitated when patients encounter long waiting times in hospitals or disorganized operations, previous studies have focused on hospital-level care coordination strategies associated with better patient experience [77]. Besides, it is envisaged that information technologies can reduce the need to craft laborious, case-by-case strategies for coordinating patient care [30,78,79].…”

Section: Discussionmentioning

confidence: 99%

What Do Patients Complain About Online: A Systematic Review and Taxonomy Framework Based on Patient Centeredness

et al. 2019

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Background Complaints made online by patients about their health care experiences are becoming prevalent because of widespread worldwide internet connectivity. An a priori framework, based on patient centeredness, may be useful in identifying the types of issues patients complain about online across multiple settings. It may also assist in examining whether the determinants of patient-centered care (PCC) mirror the determinants of patient experiences. Objective The objective of our study was to develop a taxonomy framework for patient complaints online based on patient centeredness and to examine whether the determinants of PCC mirror the determinants of patient experiences. Methods First, the best fit framework synthesis technique was applied to develop the proposed a priori framework. Second, electronic databases, including Web of Science, Scopus, and PubMed, were searched for articles published between 2000 and June 2018. Studies were only included if they collected primary quantitative data on patients’ online complaints. Third, a deductive and inductive thematic analysis approach was adopted to code the themes of recognized complaints into the framework. Results In total, 17 studies from 5 countries were included in this study. Patient complaint online taxonomies and theme terms varied. According to our framework, patients expressed most dissatisfaction with patient-centered processes (101,586/204,363, 49.71%), followed by prerequisites (appropriate skills and knowledge of physicians; 50,563, 24.74%) and the care environment (48,563/204,363, 23.76%). The least dissatisfied theme was expected outcomes (3651/204,363, 1.79%). People expressed little dissatisfaction with expanded PCC dimensions, such as involvement of family and friends (591/204,363, 0.29%). Variation in the concerns across different countries’ patients were also observed. Conclusions Online complaints made by patients are of major value to health care providers, regulatory bodies, and patients themselves. Our PCC framework can be applied to analyze them under a wide range of conditions, treatments, and countries. This review has shown significant heterogeneity of patients’ online complaints across different countries.

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Section: Discussionmentioning

confidence: 99%

What Do Patients Complain About Online: A Systematic Review and Taxonomy Framework Based on Patient Centeredness

et al. 2019

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“…Better health care depends on improvements not only in technical elements and treatments to alleviate physical limitations but also in the delivery of a comfortable experience that allows patients to better engage and navigate health-care systems in pursuing better health 35 . This is reflected by the expansion of quality improvement initiatives within current health-care organizations in areas such as communication (e.g., telephone contact/messaging systems) and care coordination (e.g., streamlining pathways and discharge) to enhance patient experience 36 .…”

Section: Discussionmentioning

confidence: 99%

Relationship Between Magnitude of Limitations and Patient Experience During Recovery from Upper-Extremity Fracture

Jayakumar

Teunis

Vranceanu

et al. 2019

JBJS OA

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Background:The relationship between the magnitude of limitations (measured by patient-reported outcome measures, or PROMs) and satisfaction with care providers and hospital services (measured by patient-reported experience measures, or PREMs) over the course of recovery after injury is unclear. The purpose of this study was to assess the relationship between a range of PROMs and 2 PREMs at 3 time points (initial office visit within a week, 2 to 4 weeks, and 6 to 9 months) after shoulder, elbow, and wrist fractures.Methods:We enrolled 744 adult patients with an isolated shoulder, elbow, or wrist fracture and invited them to complete PROMs (the Patient-Reported Outcomes Measurement Information System Upper Extremity Physical Function computer adaptive test [PROMIS UE], PROMIS Physical Function (PROMIS PF) scale, Quick Disabilities of the Arm, Shoulder and Hand [QuickDASH] questionnaire, EuroQol 5-Dimensions 3-Level Index [EQ-5D-3L], and Oxford Shoulder Score [OSS], Oxford Elbow Score [OES], or Patient-Rated Wrist Evaluation [PRWE]) and PREMs (Numerical Rating Scale [NRS] for satisfaction with care providers [NRS-C] and for satisfaction with hospital services [NRS-S]) at their initial visit at the outpatient surgical practice (maximum, 1 week after the fracture), between 2 and 4 weeks after the injury, and between 6 and 9 months after the injury. Correlational analysis was performed at each time point.Results:There was moderate correlation between the PROMIS UE and the NRS-C (r = 0.56) and NRS-S (r = 0.59) at 6 to 9 months after injury, which was stronger than the correlation at the 2 to 4-week mark (NRS-C, r = 0.34; NRS-S, r = 0.36) and at the evaluation that took place within a week after the injury (NRS-C, r = 0.18; NRS-S, r = 0.16). These correlational trends were observed with all forms of PROMs. Patients reporting greater limitations after injury were also less satisfied with their care and services.Conclusions:The increasing alignment of PROMs and PREMs over the course of recovery after an upper-extremity fracture suggests that restored physical function may improve perceptions of satisfaction with care providers and hospital services over time. Future studies should assess factors that could be addressed to improve patient satisfaction and their limitations during recovery after fracture in order to maximize patient outcomes.Level of Evidence:Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.

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“…Integrated care, defined as "care that is coordinated across professionals, facilities, and support systems; continuous over time and between visits; tailored to the patients' needs and preferences; and based on shared responsibility between patient and caregivers for optimizing health," 11 has a substantial influence on patient outcomes and overall patient experience. [12][13][14] Integrated care is ideally measured by patients and families who are positioned to observe the totality of care through the course of managing an illness. 15,16 It is especially needed for the management of patients with complex, chronic conditions, which often requires services from several specialties and nonmedical disciplines.…”

Section: Introductionmentioning

confidence: 99%

“…Understanding whether patients perceive their care as integrated may be especially useful for understanding and improving integrated care. Integrated care, defined as “care that is coordinated across professionals, facilities, and support systems; continuous over time and between visits; tailored to the patients’ needs and preferences; and based on shared responsibility between patient and caregivers for optimizing health,” 11 has a substantial influence on patient outcomes and overall patient experience 12‐14 . Integrated care is ideally measured by patients and families who are positioned to observe the totality of care through the course of managing an illness 15,16 .…”

Section: Introductionmentioning

confidence: 99%

Differences in patient perceptions of integrated care among black, hispanic, and white Medicare beneficiaries

Ling

Frean

et al. 2021

Health Services Research

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Objective: This study sought to identify potential disparities among racial/ethnic groups in patient perceptions of integrated care (PPIC) and to explore how methodological differences may influence measured disparities. Data Source: Data from Medicare beneficiaries who completed the 2015 Medicare Current Beneficiary Survey (MCBS) and were enrolled in Part A benefits for an entire year.Study Design: We used 4-point measures of eight dimensions of PPIC and assessed differences in dimensions among racial/ethnic groups. To estimate differences, we applied a "rank and replace" method using multiple regression models in three steps, balancing differences in health status among racial groups and adjusting for differences in socioeconomic status. We reran all analyses with additional SES controls and using standard multiple variable regression. Data Collection/Extraction Methods: Not applicable.Principal Findings: We found several significant differences in perceived integrated care between Black versus White (three of eight measures) and Hispanic versus White (one of eight) Medicare beneficiaries. On average, Black beneficiaries perceived more integrated support for self-care than did White beneficiaries (mean difference = 0.14, SE = 0.06, P =.02). Black beneficiaries perceived more integrated specialists' knowledge of past medical history than did White beneficiaries (mean difference = 0.12, SE = 0.06, P =.01). Black and Hispanic beneficiaries also each reported, on average, 0.18 more integrated medication and home health management than did White beneficiaries (P <.01 and P <.01). These findings were robust to sensitivity analyses and model specifications. Conclusions:There exist some aspects of care for which Black and Hispanic beneficiaries may perceive greater integrated care than non-Hispanic White beneficiaries.Further studies should test theories explaining why racial/ethnic groups perceive differences in integrated care.

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Hospital-level care coordination strategies associated with better patient experience

Abstract: Hospitals with greater reported use of care coordination and transition strategies have better patient experience than hospitals with fewer reported strategies. Strategies that most directly involve patients have the strongest association with better experience.

Cited by 19 publications

References 16 publications

What Do Patients Complain About Online: A Systematic Review and Taxonomy Framework Based on Patient Centeredness

What Do Patients Complain About Online: A Systematic Review and Taxonomy Framework Based on Patient Centeredness

Relationship Between Magnitude of Limitations and Patient Experience During Recovery from Upper-Extremity Fracture

Differences in patient perceptions of integrated care among black, hispanic, and white Medicare beneficiaries

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